Insurance Claims Officer

Tasks & duties

Insurance claims officers may do some or all of the following:

• analyse the claim and decide whether it is covered by the policy
• appoint insurance loss adjusters and private investigators when required
• manage long-term claims and reassess them regularly
• make recommendations for the settlement of claims
• inform clients if claims are accepted and how they will be allocated
• organise payments to clients
• organise the repair or replacement of lost items
• make sure all enquiries and payments are dealt with quickly
• keep clients' files updated
• record payments made and received
• contact independent experts in the case of disputes and attend disputes tribunals

Specialisations

Insurance claims officers may specialise in general insurance, which includes house and contents, commercial, motor vehicle and marine insurance; or life insurance, which includes health insurance, disability insurance and superannuation.

Skills & knowledge

Insurance claims officers need to have:

• understanding of the insurance industry, particularly the area they work in, such as fire, life, accident or marine insurance
• knowledge of insurance policies, including what each policy covers
• an understanding of relevant laws, such as the Privacy Act and the Human Rights Act
• knowledge of their company's insurance policies
• good communication and negotiating skills
• report writing skills
• skills in analysing and interpreting information, including legal documents
• organisational skills

It is also useful if insurance claims officers understand the risks involved in different occupations.

Entry requirements

There are no specific entry requirements to become an insurance claims officer, but some employers may prefer you to have completed tertiary training. Medical or paramedical qualifications are helpful for insurance claims officers working in the area of health, disability or life insurance.

Secondary education

A tertiary entrance qualification with skills in English and maths is preferred.

Training on the job

Skills are gained on the job. Insurance claims officers attend in-house training and private courses in their specialist area.

The Australian and New Zealand Institute of Insurance and Finance (ANZIIF) offers courses to diploma level in general and life insurance that focus on developing technical insurance skills for claims staff.

Useful experience

Useful experience includes previous work experience within the insurance industry, such as in underwriting, sales or customer service. Work in the legal, customer service, health, finance or banking industries may also be useful.

Related courses

Insurance and Actuarial Studies

For more information, please refer to Career Services.